冠状动脉扩张患者与阻塞性冠状动脉疾病患者新蝶呤水平的比较。

Sahin Mehmet, Varol Ercan, Ozaydin Mehmet, Altinbas Ahmet, Aydin Osman, Aslan Suleyman M, Dogan Abdullah, Kaya Selçuk

Department of Internal Medicine, Suleyman Demirel University, Isparta, Turkey.

South Med J. 2008 May;101(5):476-9. doi: 10.1097/SMJ.0b013e31815d22f4.

OBJECTIVES

Inflammation has been reported as an important component of vascular aneurysm formation, as found in obstructive vascular disorder. Neopterin is produced by activated macrophages and is thought to represent a marker of immune activation and macrophage activity. The plasma neopterin levels were investigated in coronary artery ectasia (CAE) patients to investigate the role of inflammation.

STUDY DESIGN

The study population consisted of three groups: the first consisted of 28 patients with isolated CAE without stenotic lesion; the second of 27 patients with obstructive coronary artery disease (O-CAD) without CAE; and the third group of 15 control subjects with normal coronary arteries (NCA). Plasma soluble neopterin levels were measured in all patients and control subjects using commercially available enzyme-linked immunosorbent assay kits.

RESULTS

Plasma neopterin levels were found to be significantly higher in patients with isolated CAE compared with control subjects with angiographically NCA (18.5 +/- 8.8 versus 8.7 +/- 2.6 nmol/L, respectively, P = 0.006). Although neopterin levels were higher in patients with CAE than in patients with O-CAD, they did not reach the statistically significant levels (18.5 +/- 8.8 versus 16.8 +/- 8.2 nmol/L, respectively, P = 0.77). Patients with O-CAD had significantly higher levels of neopterin compared with subjects with angiographically NCA (16.8 +/- 8.2 versus 8.7 +/- 2.6 nmol/L, respectively, P = 0.03). The mean serum neopterin levels in patients with single-vessel, two-vessel, and diffuse ectasia were as follows: 17.4 +/- 9.9 nmol/L, 19.5 +/- 8.9 nmol/L, and 20 +/- 5.5 nmol/L, respectively (P = 0.4).

CONCLUSION

Patients with isolated CAE have raised levels of neopterin compared with patients with NCA, showing the possible role of inflammatory processes (monocyte/macrophage activity) in the higher levels of neopterin in patients with O-CAD.

目的

炎症被报道为血管动脉瘤形成的一个重要组成部分，如在阻塞性血管疾病中所见。新蝶呤由活化的巨噬细胞产生，被认为是免疫激活和巨噬细胞活性的标志物。本研究检测了冠状动脉扩张（CAE）患者的血浆新蝶呤水平，以探讨炎症的作用。

研究设计

研究人群包括三组：第一组由28例无狭窄病变的孤立性CAE患者组成；第二组由27例无CAE的阻塞性冠状动脉疾病（O-CAD）患者组成；第三组为15例冠状动脉正常（NCA）的对照受试者。使用市售的酶联免疫吸附测定试剂盒检测所有患者和对照受试者的血浆可溶性新蝶呤水平。

结果

与血管造影显示冠状动脉正常的对照受试者相比，孤立性CAE患者的血浆新蝶呤水平显著更高（分别为18.5±8.8与8.7±2.6 nmol/L，P = 0.006）。虽然CAE患者的新蝶呤水平高于O-CAD患者，但未达到统计学显著水平（分别为18.5±8.8与16.8±8.2 nmol/L，P = 0.77）。与血管造影显示冠状动脉正常的受试者相比，O-CAD患者的新蝶呤水平显著更高（分别为16.8±8.2与8.7±2.6 nmol/L，P = 0.03）。单支血管、两支血管和弥漫性扩张患者的平均血清新蝶呤水平如下：分别为17.4±9.9 nmol/L、19.5±8.9 nmol/L和20±5.5 nmol/L（P = 0.4）。